Nursing Elites

1. A unit director at a local hospital knows even leadership may face ethical dilemmas. Which of the following should the director take into consideration when dealing with an employee who is incompetent?

• A. The situation should be tolerated for as long as possible because of the amount of time and paperwork required to terminate an incompetent nurse.
• B. Incompetence only impacts the individual nurse.
• C. The director should follow her institution�s formal process for reporting and handling practices that jeopardize patient safety.
• D. Most nurse practice acts direct how to handle incompetent nurses.

Correct answer: C

Rationale: The director should follow her institution�s formal process for reporting and handling practices that jeopardize patient safety.

2. A client is refusing a blood transfusion for religious reasons. The client's partner wants the client to have the blood transfusion. Which of the following actions should be taken?

• A. Ask the client to consider a direct donation
• B. Withhold the blood transfusion
• C. Ask the client to consider a direct donation
• D. Request a consultation with the ethics committee

Correct answer: A

Rationale: In this situation, the nurse should ask the client to consider a direct donation. This option respects the client's autonomy by exploring alternative options that align with the client's beliefs. Withholding the blood transfusion (choice B) goes against the client's wishes and autonomy. Requesting a consultation with the ethics committee (choice D) should be considered if there is a disagreement that cannot be resolved at the bedside, but it is not the initial step. Choice C is a duplicate of choice A and does not provide a different or additional action to address the situation.

3. When a nurse observes a fellow nurse preparing an incorrect dose of medication, what is the best action to take?

• A. Ignore the error
• B. Administer the medication anyway
• C. Correct the error without informing the nurse
• D. Report the error to the supervisor immediately

Correct answer: D

Rationale: The best action to take when a nurse observes a fellow nurse preparing an incorrect dose of medication is to report the error to the supervisor immediately. Reporting the error is crucial to ensure patient safety and prevent any potential harm. Ignoring the error (Choice A) is not appropriate as it puts the patient at risk. Administering the medication anyway (Choice B) could harm the patient. Correcting the error without informing the nurse (Choice C) does not address the root cause of the issue, which should be brought to the attention of the supervisor for proper investigation and resolution.

4. When planning to run for the local school board, which of the following sources of power would a nurse find important?

• A. Connection
• B. Reward
• C. Charisma
• D. Expertise

Correct answer: A

Rationale: When a nurse is planning to run for the local school board, the important source of power would be 'Connection.' In politics, building relationships and forming connections are crucial for gaining support, forming coalitions, and accessing valuable information. Being charismatic is not a necessary attribute for utilizing power effectively in this context. While expertise is valuable, especially in education-related matters, it is not specified as a primary source of power for a political candidate. Rewards are not typically within the purview of a candidate running for a position such as the local school board.

5. When a client is receiving pain medication through a PCA pump, which of the following actions should the nurse take?

• A. Educate the family not to push the button for the client while the client is asleep.
• B. Explain to the client that vital signs will be monitored regularly due to being on a PCA pump.
• C. Instruct the client to push the button only when pain is above a 7 on a scale of 0 to 10.
• D. Adjust the basal rate and decrease the lock-out interval time if the client's pain level is too high.

Correct answer: D

Rationale: When a client is receiving pain medication through a PCA pump, it is essential to adjust the settings if their pain level is not adequately controlled. Increasing the basal rate and shortening the lock-out interval time can help manage the client's pain more effectively. This adjustment should be made by the healthcare provider based on the client's pain assessment and response to the current settings. It is crucial to individualize the PCA pump settings to optimize pain management for each client. Choices A, B, and C are incorrect because educating the family not to push the button, explaining vital sign monitoring, and setting a specific pain level for button pushing are not direct actions the nurse should take to adjust the PCA pump settings for effective pain management.

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